Percorrer por autor "Bento, Alexandra"
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- Abordagem da obesidade infantil através do Objetivo de Desenvolvimento Sustentável 3 – Saúde e Bem-Estar : a contribuição do Centro Colaborativo da OMS para Nutrição e Obesidade InfantilPublication . Rito, Ana; Gaspar, Marta; Alvito, Paula; Bento, Alexandra; Santos, Cristina AbreuA obesidade infantil constitui um dos maiores desafios de saúde pública do século XXI e representa uma ameaça significativa para o cumprimento do Objetivo de Desenvolvimento Sustentável 3 (ODS 3) – Saúde e Bem-Estar, definido pela Agenda 2030 das Nações Unidas. Este artigo analisa criticamente a relação entre a obesidade infantil e o ODS3, com especial enfoque no papel desempenhado pelo Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), enquanto Centro Colaborativo da Organização Mundial da Saúde (OMS) para Nutrição e Obesidade Infantil (CCOMS). Foi realizada uma revisão da literatura científica publicada entre 2020 e 2025, tendo sido identificadas 379 publicações das quais 19 artigos científicos sujeitos a arbitragem por pares foram incluídos na análise final. Seis estudos forneceram evidência direta sobre a relação entre obesidade infantil e o ODS 3, com particular ênfase na meta 3.4, evidenciando a obesidade infantil como fator determinante nas doenças não transmissíveis sublinhando a relevância de dados epidemiológicos e reforçando a necessidade de estratégias intersetoriais e prevenção e promoção da saúde. Os resultados destacaram ainda a escassez de literatura abrangente que articule soluções sustentáveis para a obesidade infantil em consonância com as metas do ODS 3. O CCOMS enquanto centro de vigilância nutricional infantil (com destaque para o estudo “Childhood Obesity Surveillance Initiative” (COSI) da OMS Europa), pelo seu apoio técnico e ação multissetorial e participação ativa na investigação e inovação científica, tem vindo a reforçar substancialmente o progresso em direção às metas do ODS 3. Em Portugal, os dados recentes do COSI revelam prevalências preocupantes de excesso de peso (31,9%) e obesidade (13,5%) em crianças, confirmando a urgência de medidas eficazes. Conclui-se que enfrentar a obesidade infantil é crucial para reduzir desigualdades em saúde e avançar no cumprimento do ODS 3, exigindo colaboração internacional e nacional, políticas públicas integradas e intervenções baseadas em evidência científica.
- Aligning Present and Future Agrifood Systems: Integrating Sustainability and Health for Better ChoicesPublication . Assunção, Ricardo; Bento, AlexandraThe transition to sustainable food systems is essential to address global challenges such as climate change, biodiversity loss and public health crises. Current food production and consumption patterns contribute to environmental degradation, while dietary choices strongly influence health outcomes and planetary sustainability. Supporting dietary decisions with robust scientific evidence is therefore essential for meaningful and informed change. This work aims to discuss the intersection of food system transitions, dietary health impacts and sustainability, highlighting the importance of a comprehensive evidence-based approach to guide decisions at individual and systemic levels. By integrating methodologies such as Risk-Benefit Assessment (RBA) and Life Cycle Sustainability Assessment (LCSA), this study provides an approach to evaluating foods, dietary patterns and food choices. RBA considers risks (e.g. food contaminants) and benefits (e.g. beneficial nutrients), while LCSA assesses the environmental, social and economic dimensions of food production and consumption. Inspired by the ALTERNATIVA project , the integration of these two perspectives, complemented by additional tools such as Multi-Criteria Decision Analysis (MCDA), will be explored and synthesised. The combination of these methodologies enables a dual-angle approach that quantifies health outcomes alongside sustainability metrics, providing a framework for balancing dietary health benefits with sustainable food systems. This approach not only informs recommendations for healthier and more sustainable diets but also supports policymakers and stakeholders in developing strategies for food system transformation. By bridging gaps between food system actors and aligning public health goals with environmental sustainability, this evidence-based framework promotes a holistic vision for the agri-food sector and empowers consumers and stakeholders to make better choices that benefit both humans and the planet.
- Aquaponics as a Novel and Alternative Food Production System: Integrating Health and Environmental Sustainability PerspectivesPublication . Assunção, Ricardo; Motta, Carla; Santos, Mariana; Batista, Rita; Albuquerque, Tânia; Bento, AlexandraAim: In an era marked by climate change, environmental resource depletion, and growing global population, the need for sustainable and resilient food systems has become increasingly urgent. Conventional food production systems contribute significantly to environmental degradation and inefficient resource use. In response, key international strategies emphasize the development of innovative solutions that foster circular economies and ensure access to nutritious and sustainable diets. Aquaponics, a closed-loop system that combines aquaculture and hydroponics, has emerged as a promising alternative, known for its efficient resource use and potential to produce nutrient-dense foods. This study aims to explore and critically assess the health and environmental sustainability impacts of aquaponically produced foods compared to conventional food systems. Method: A structured literature review and critical evaluation of peer-reviewed studies were conducted to identify key health and environmental sustainability indicators associated with aquaponic food production. Health-related factors included the presence of nutrients and potential contaminants (chemical and microbiological), while environmental assessment focused on Life Cycle indicators such as global warming potential, eutrophication, water footprint, land use, acidification, and ecotoxicological impact. Studies were selected based on comparability to conventional food production systems. Results: The obtained results indicated that aquaponic systems can produce foods with comparable or enhanced nutritional profiles relative to conventional systems. On the environmental side, aquaponics demonstrated reduced water use, land requirements, and nutrient discharge, though energy use and system complexity vary depending on design and operational parameters. Life Cycle indicators highlighted significant reductions in eutrophication and land use impacts, particularly when fish and plants are optimally integrated. Conclusion: Aquaponics presents a viable and innovative approach to future food production, offering measurable health and environmental benefits compared to traditional systems. However, broader adoption will require further research to provide evidence-based integration into food policy frameworks. These findings support the potential of aquaponics as a sustainable alternative aligned with the food system transformation goals.
- Bolachas de arroz e/ou milho: uma opção saudável no lanche escolar?Publication . Albuquerque, T.G.; Silva, Mafalda Alexandra; Bento, Alexandra; Costa, H.S.A infância é crucial para desenvolver hábitos alimentares saudáveis e o ambiente escolar desempenha um papel vital na formação desses hábitos. Os lanches escolares muitas vezes caracterizam-se por qualidade nutricional pobre, sendo ricos em sal, açúcar e gordura saturada. Bolachas de arroz e/ou milho são frequentemente associadas a uma opção mais saudável. Ferramentas como a Estratégia Integrada para a Promoção da Alimentação Saudável (EIPAS), o Guia para Lanches Escolares Saudáveis, os sistemas de rotulagem front-of-pack, como o descodificador de rótulos (traffic-light) e o Nutri-Score, e os modelos de perfil nutricional, permitem-nos avaliar a qualidade nutricional destes produtos e podem auxiliar na elaboração de outras recomendações. Pretende-se avaliar a informação nutricional de bolachas de arroz e/ou milho disponíveis no mercado português e, através da aplicação de ferramentas de avaliação da qualidade nutricional, orientações para uma alimentação saudável, e instrumentos de educação alimentar, estimar o potencial impacto na saúde pública. Foram analisados 175 tipos de bolachas, identificando-se desafios na quantidade de sal, uma vez que apenas 42% atingem a meta (inferior a 0,3 g/100 g) da EIPAS. Apesar de alguns produtos satisfazerem os limites de açúcares, há necessidade de reformulação, especialmente nas bolachas de arroz ou milho com cobertura. O descodificador de rótulos e o Nutri-Score permitem identificar diferenças marcantes entre bolachas simples e com cobertura, podendo ser profícuos no auxílio ao consumidor a realizar a sua escolha informada e consciente. A análise utilizando os modelos de perfil nutricional da Direção-Geral da Saúde e Organização Mundial da Saúde ressaltou a importância de limitar a publicidade dirigida a crianças. Em conclusão, este trabalho enfatiza a necessidade de ações multidisciplinares, estratégias de reformulação e de educação alimentar. Espera-se que tais medidas promovam escolhas alimentares mais seguras e saudáveis, contribuindo para ambientes salutogénicos e para a saúde pública.
- Commercial Baby Foods Aimed at Children up to 36 Months: Are They a Matter of Concern?Publication . Santos, Mariana; Matias, Filipa; Loureiro, Isabel; Rito, Ana Isabel; Castanheira, Isabel; Bento, Alexandra; Assunção, RicardoProper nutrition in infancy and early childhood is crucial to ensuring optimal child development, growth, and better health outcomes later in life. The nutrient profile model proposed by WHO/Europe aims to assess the nutritional quality and promotional/marketing aspects of commercial baby foods aimed at children up to 36 months. We used commercial data from 191 baby foods collected between March 2021 and July 2021, from eight supermarket chains in the Lisbon Metropolitan area. According to the model specifications and the NOVA classification system, we assessed the nutritional quality and promotion aspects and the degree of processing, respectively. The presence of at least one sugar-contributing ingredient was found in 34.0% of the products; 13.9% of products listed sugars and 15.0% listed fruit juices or concentrates as an ingredient. The claim “No added sugar” was present in 69.6% of products. Only 35.1% of products comply with all the nutritional requirements of the model. Concerning processing classification, 61.8% of products were ultra-processed, and about 57.0% were indicated for children < 12 months. These findings reinforce the importance of implementing measures to ensure that commercial foods for infants are marketed appropriately and to promote foods with a lower degree of processing.
- Family wealth inequalities in Portuguese children's health-related quality of life according to weight status - findings from COSI/WHO Europe studyPublication . Rito, Ana Isabel; Martins, Maria de Fátima; Gaspar, Marta; Bento, Alexandra; Abreu Santos, CristinaIntrodution: Health-Related Quality of Life (HRQoL) is a multidimensional concept encompassing aspects of quality of life that directly or indirectly relate to health, such as physical, psychological, and social well-being. The interplay between socioeconomic factors, like family earnings and weight status impacts children’s HRQoL, highlighting the importance of addressing these factors to promote health equity from an early age. Methods: This observational cross-sectional study analyzed data from the 6th WHO European Childhood Obesity Surveillance Initiative, the COVID study in Portugal, targeting primary school-age children. BMI was calculated using WHO reference growth charts for children, and data on children's HRQoL and family perceived wealth was obtained through a family form, reporting data during the COVID-19 pandemic (March 2020-June 2022). HRQoL was assessed using the KIDSCREEN-10 parent report, with Rasch scores calculated and transformed into T-scores. Higher values indicate higher levels of HRQoL. Family perceived wealth reflects how easily a family meets monthly expenses using their earnings. It is categorized as “low” (combining the answers “we have trouble meeting the end of the month with our earnings” and “we barely meet the end of the month with our earnings”), “medium” (“we meet the end of the month with their own earnings without serious problems”), and “high” (“we easily met the end of the month with their own earnings”). Results: Among the 3279 children analysed, 12.0% were classified as having obesity, with a higher proportion of boys (51.8%) than girls (48.2%). After adjusting for sex and age, the linear regression coefficients showed that family perceived wealth was positively associated with HRQoL in both groups (without obesity: medium compared with low 2.548, 95% CI: 1.398;3.699, p<0.001 and high compared with low perceived health 4.240, 95% CI: 2.953;5.527, p<0.001; with obesity: medium compared with low 3.671, 95% CI: 0.810;6.532, p=0.012 and high compared with low perceived health 3.850, 95% CI: 0.516;7.184, p=0.024). General linear regression also showed that family perceived wealth demonstrates a clear gradient effect in both groups. The differences in age and sex-adjusted mean scores between the lowest and the medium and higher perceived wealth levels were statistically significant for HRQoL scores (47.64 for high, p<0.001, 45.93 for medium, p=0.003, and 43.38, p<0.001, for low in children without obesity; 48.04, 47.85, and 44.19 respectively in children with obesity, with p=0.038 for the lowest category). Conclusion: Findings suggest that family perceived family wealth significantly influences children's HRQoL, regardless of BMI. The relationships between this factor and HRQoL emphasize the need for multifaceted interventions that address both family socioeconomic circumstances and weight status to improve children's health and well-being.
- Front-of-pack labelling policies and the need for guidancePublication . Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Miraldo, Marisa; Calhau, Conceição; Bento, Alexandra; Cruz, Diogo; Almeida, Fernando; Darzi, Ara; Araújo, FernandoFood labels are a challenge for most consumers, and the development of easily understandable labelling is essential when it comes to empowering consumers in making healthier food choices. (...)
- Os institutos de saúde pública e o combate às alterações climáticas [editorial]Publication . Bento, AlexandraA investigação constitui uma das principais atividades do Departamento de Alimentação e Nutrição (DAN) do Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA) sendo desenvolvida de forma intensa, em domínios muito diversos, de que são exemplos os artigos publicados nesta edição do Boletim Epidemiológico Observações. Um dos contributos emergentes para a saúde pública em Portugal é, sem dúvida, a investigação para o combate às alterações climáticas. O tema esteve em discussão na recente reunião da International Association of National Public Health Institute (IANPHI), onde o INSA, enquanto um dos 115 membros dos 98 países representados, participou de forma destacada. Os Institutos Nacionais de Saúde Pública (INSP) são essenciais na conceção de políticas de adaptação baseadas em evidências (preparação e prevenção de emergências, entre outras) e no apoio a políticas de mitigação (por exemplo, promoção de intervenções sobre determinantes-chave da saúde, como dietas e estilos de vida). Deste domínio a IANPHI desenvolveu um interessante roteiro para reforçar o papel dos INSP nas políticas de mitigação e adaptação às alterações climáticas. (...)
- Nutri-Score: a public health tool to improve eating habits in PortugalPublication . Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Gregório, Maria João; Nunes, Alexandre Morais; Calhau, Conceição; Hercberg, Serge; Rito, Ana; Bento, Alexandra; Cruz, Diogo; Almeida, Fernando; Darzi, Ara; Araújo, FernandoThis article intends to help filling the existing gap in guidance for the implementation of FOP labelling systems.4 As such, the following sections present the growing evidence on the impact of the Nutri-Score labelling scheme in promoting healthier eating behaviours and informs health professionals, as well as decision makers, on the way forward.
- Portugal’s voluntary food reformulation agreement and the WHO reformulation targetsPublication . Goiana-da-Silva, Francisco; Cruz-e-Silva, David; Allen, Luke; Nunes, Alexandre Morais; Calhau, Conceição; Rito, Ana; Bento, Alexandra; Miraldo, Marisa; Darzi, AraIn response to stalling progress in NCD related premature mortality, the Portuguese government declared the ‘Promotion of Healthy Eating’ a national priority and convened a multisectoral task force with representatives from several ministries in order to tackle unhealthy diets. With the inputs from civil society, non-governmental organisations and health authorities, this task force developed the Integrated Strategy for the Promotion of Healthy Eating (Estratégia Integrada para a Promoção da Alimentação Saudável – “EIPAS”). The strategy – endorsed by the Portuguese Ministers Council in December 2017 – included fiscal measures, co-regulation agreements with the food industry, enhanced cooperation with municipalities, and measures to change the food environments in public settings among many other initiatives. In December 2016, the Portuguese Parliament approved a special consumption tax on sweetened beverages which has been associated with product reformulation and a fall in sales. Inspired by the success of the tax on sweetened beverages, in December 2018, the government proposed a tax on salty processed foods; as salt is the leading dietary risk factor for NCDs in Portugal. Even though the average consumption is 10.7g/d far above of the WHO recommended threshold of <5g/d, the majority of the Portuguese Parliament Members voted against this proposal, recommending instead a co-regulation agreement with the food industry to achieve similar changes in consumption of salt. After one year of negotiations, the Portuguese Ministry of Health (MoH) and the food industry representatives signed a broad ‘Food Industry Co-regulation Agreement’ on the 2nd of May 2019. The agreement covers the main food products high in salt, sugar, and trans fatty acids as well as the main dietary sources of these nutrients for the Portuguese population.(...)